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Nerve transfer for sensory reconstruction of C8‐T1 dermatomes in tetraplegia
Author(s) -
Bertelli Jayme A.,
Ghizoni Marcos F.
Publication year - 2016
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.30088
Subject(s) - medicine , dermatome , tetraplegia , ulnar nerve , microsurgery , forearm , sensation , anatomy , sensory system , cutaneous nerve , spinal cord injury , sensory nerve , median nerve , elbow , radial nerve , surgery , spinal cord , neuroscience , psychiatry , biology
Objectives Absence of sensation in C8‐T1 dermatome is a common finding in midcervical spinal cord injury. The goal was to restore sensation on the C8‐T1 dermatomes by transferring sensory nerves with afferents on C5‐C6 roots. Methods A mean 10 months post spinal cord injury, we operated on 10 upper limbs from 5 tetraplegics averaging 23 years old. Cutaneous branches of the median nerve were transferred to the palm to the ulnar proper digital nerve of the little finger. In two patients, the lateral antebrachial cutaneous nerve was also transferred to the medial antebrachial cutaneous nerve. Results At a mean 20 months after surgery, on the ulnar side of the hand and little finger, all patients were able to perceive 19.3 g Semmes–Weinstein monofilament pressure. Nociception was restored on the medial side of the elbow, forearm, and hand. Faulty location was a common finding, but not as a major complaint. Conclusions Sensory nerve transfers should be incorporated into the reconstruction of the upper limb in tetraplegics. © 2015 Wiley Periodicals, Inc. Microsurgery 36:637–641, 2016.